Tuberculosis (TB) is a bacterial infection caused by a germ called Mycobacterium tuberculosis.
The bacteria usually attack the lungs, but they can also damage other parts of the body. TB spreads through the air when a person with TB of the lungs or throat coughs, sneezes or talks. If you have been exposed, you should go to your doctor for tests. You are more likely to get TB if you have a weak immune system. Symptoms of TB in the lungs may include: A bad cough that lasts 3 weeks or longer Weight loss Coughing up blood or mucus Weakness or fatigue Fever and chills Night sweats Causes: All cases of TB are passed from person to person via droplets. When someone with TB infection coughs, sneezes, or talks, tiny droplets of saliva or mucus are expelled into the air, which can be inhaled by another person. Once infectious particles reach the alveoli (small saclike structures in the air spaces in the lungs), another cell, called the macrophage, engulfs the TB bacteria.
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Then the bacteria are transmitted to the lymphatic system and bloodstream and spread to other organs occurs. The bacteria further multiply in organs that have high oxygen pressures, such as the upper lobes of the lungs, the kidneys, bone marrow, and meninges -- the membrane-like coverings of the brain and spinal cord.
When the bacteria cause clinically detectable disease, you have TB. People who have inhaled the TB bacteria, but in whom the disease is controlled, are referred to as infected. Their immune system has walled off the organism in an inflammatory focus known as a granuloma. They have no symptoms, frequently have a positive skin test for TB, yet cannot transmit the disease to others. This is referred to as latent tuberculosis infection or LTBI.
Risk factors for TB include the following: HIV infection, low socioeconomic status, alcoholism, homelessness, crowded living conditions,
diseases that weaken the immune system, migration from a country with a high number of cases, and health-care workers.
Diagnostic Examination: Chest X-ray: The most common diagnostic test that leads to the suspicion of infection is a chest X-ray. In primary TB, an X-ray will show an abnormality in the mid and lower lung fields, and lymph nodes may be enlarged.
Reactivated TB bacteria usually infiltrate the upper lobes of the lungs. Miliary tuberculosis exhibits diffuse nodules at different locations in the body.
Mantoux skin test also known as a tuberculin skin test (TST or PPD test): This test helps identify people infected with M. tuberculosis but who have no symptoms. A doctor must read the test. The doctor will inject 5 units of purified protein derivative (PPD) into your skin. If a raised bump of more than 5 mm (0.2 in) appears at the site 48 hours later, the test may be positive.
This test can often indicate disease when there is none (false positive). Also, it can show no disease when you may in fact have TB (false negative).
Sputum testing: Sputum testing for acid-fast bacilli is the only test that confirms a TB diagnosis. If sputum (the mucus you cough up) is available, or can be induced, a lab test may give a positive result in up to 30% of people with active disease. Sputum or other bodily secretions such as from your stomach or lung fluid can be cultured for growth of mycobacteria to confirm the diagnosis.
It may take one to three weeks to detect growth in a culture, but eight to 12 weeks to be certain of the diagnosis.
Prognosis: With treatment, your chance of full recovery is very good.
Without treatment, the disease will progress and lead to disability and death.